Venting a feeding tube to manage fullness and bloating

What are G and GJ tubes?

Gastrostomy tubes (G tubes) and gastrojejunostomy tubes (GJ tubes) are feeding devices. A G tube gives liquid nutrition, medication and other fluids directly into the stomach. A GJ tube gives liquid nutrition, medication and other fluids directly into the small intestine (the jejunum). Both G tubes and GJ tubes are placed in a surgical opening in your child's tummy (abdomen) called the stoma. The tunnel from the outside into the stomach is called the tract.

What is venting?

Venting a G tube means letting gas from your child's stomach out through the end of the G tube. Venting before a feed allows air to escape the stomach before it is filled. This helps to prevent fullness and bloating.

Do not vent a GJ or J tube.

What are fullness and bloating?

If your child experiences pain or discomfort during feeds, or is vomiting or burping, they may be feeling full or bloated. This may be caused by:

• giving feeds too quickly
• giving too large a volume of feed
• swallowing air or giving extra air through the feeding tube during feeds
• constipation
  

How to vent a G tube

Each of these techniques can be used for any style of G tube. If your child's tube requires an extension set, this must be attached when you try to vent the tube.

Leaving the end of the tube open to vent

You will need the following supplies:

• Washcloth
• Syringe with water for flushing the tube

Follow these steps:

1. Open the end of the G tube, resting the tube on a washcloth
2. If needed, unclamp the tube
3. After venting, flush the G tube with water to clear the tube and clamp the tube

You may gently massage the stomach to help push the air out of the tube.

Using a syringe to vent

You will need the following supplies:

• A large catheter tip syringe
• Syringe with water for flushing the tube

Follow these steps:

1. Pull the plunger out of the syringe
2. Open the end of the G tube (For a low-profile balloon G tube, you will need to attach the bolus/venting extension set)
3. Attach the syringe, without the plunger, to the of the G tube
4. Position the tube and syringe above the child’s stomach, allowing air to rise
5. If needed, unclamp the tube
6. After venting, remove the syringe and flush the G tube with water to clear the tube and clamp the tube

You may gently massage the stomach to help push the air out of the tube.

Manually venting a feeding tube

You will need the following supplies:

• A large catheter tip syringe
• Syringe with water for flushing

Follow these steps:

1. Open the end of the G tube
2. Attach the syringe to the of the G tube
3. If needed, unclamp the tube
4. Slowly pull back on the syringe to remove air from the stomach
5. After venting, remove the syringe and flush the G tube with water to clear the tube
6. If needed, clamp the tube

You may gently massage the stomach to help push the air out of the tube.

Using a Farrell Valve System to vent

You will need the following supplies:

• Farrell Valve System

Follow these steps:

1. Hang the Farrell bag on the pole at the same height as the feeding pump
2. Close the white roller clamp and blue clamp on the Farrell Bag
3. Attach the primed feeding bag to the Y port on the Farrell bag
4. Open the white roller clamp on the Farrell bag and prime the feeding bag allowing some feed to go up the Farrell bag
5. Close the white roller clamp on the Farrell bag
6. Open the blue clamp on the Farrell bag and prime the feeding bag tubing all the way to the end
7. Flush the tube
8. Attach the Farrell bag, with the feeding bag connected to it, to the feeding tube
9. Position the Y port on the Farrell Bag at or below the stomach
10. Open all the clamps and rollers and start feeds

The feed will move up and down the Farrell bag line. The Farrell bag will not fill up with air as there is a vent to allow air to escape. If the bag fills with formula, the tube may be blocked; if this happens, follow the instructions for unblocking the tube from the article What to do if your child's feeding tube is blocked.

To give medications, close the blue clamp on the Farrell bag and give medicatinos directly into the feeding tube. Wait at least 30 minutes after giving medications to start venting again.

If your child has a combination G/GJ tube, you can feed into the jejunum at the same time as you vent from the stomach.

Other way to manage fullness and bloating problems at home

To deal with fullness and bloating problems, you can:

• Decrease the feeding rate to see if slower feeds help ease digestion.
• Stop the feed for one to two hours and restart at a slower rate (if you cannot reach the maximum rate after slowly increasing, call your child’s dietitian, , or nurse practitioner).
• Vent the G tube before feeds.
• Ask your child’s doctor to help manage your child’s constipation. Discuss with your child’s dietitian, doctor or nurse practitioner before decreasing or making changes to your child’s feed.